Provider Demographics
NPI:1144030016
Name:NOLAN, VICTORIA MARIE (PA-S)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MARIE
Last Name:NOLAN
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 OLD LANCASTER RD APT A410
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-1361
Mailing Address - Country:US
Mailing Address - Phone:570-309-2307
Mailing Address - Fax:
Practice Address - Street 1:750 OLD LANCASTER RD APT A410
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1361
Practice Address - Country:US
Practice Address - Phone:570-309-2307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program